Nitrofur-C - General Information:

A urinary anti-infective agent effective against most gram-positive and gram-negative organisms. Although sulfonamides and antibiotics are usually the agents of choice for urinary tract infections, nitrofurantoin is widely used for prophylaxis and long-term suppression. [PubChem]

Nitrofur-C - Pharmacology:

Nitrofur-C for patients

Patients should be advised to take Macrobid with food (ideally breakfast and dinner) to further
enhance tolerance and improve drug absorption. Patients should be instructed to complete the full course of therapy;
however, they should be advised to contact their physician if any unusual symptoms occur during therapy.

Patients should be advised not to use antacid preparations containing magnesium trisilicate while
taking Macrobid.

Patients should be counseled that antibacterial drugs including Macrobid should only be used to
treat bacterial infections. They do not treat viral infections (e.g., the common cold). When Macrobid is
prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in
the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full
course of therapy may (1) decrease the effectiveness of the immediate treatment and (2) increase the likelihood that
bacteria will develop resistance and will not be treatable by Macrobid or other antibacterial drugs in the
future.

Nitrofur-C Interactions

Antacids containing magnesium trisilicate, when administered concomitantly with nitrofurantoin, reduce
both the rate and extent of absorption. The mechanism for this interaction probably is adsorption of nitrofurantoin
onto the surface of magnesium trisilicate.

Uricosuric drugs, such as probenecid and sulfinpyrazone, can inhibit renal tubular secretion of
nitrofurantoin. The resulting increase in nitrofurantoin serum levels may increase toxicity, and the decreased
urinary levels could lessen its efficacy as a urinary tract antibacterial.

Drug/Laboratory Test Interactions

As a result of the presence of nitrofurantoin, a false-positive reaction for glucose in the urine may
occur. This has been observed with Benedictís and Fehlingís solutions but not with the glucose
enzymatic test.

Nitrofur-C Contraindications

Anuria, oliguria, or significant impairment of renal function (creatinine clearance under 60 mL per
minute or clinically significant elevated serum creatinine) are contraindications. Treatment of this type of patient
carries an increased risk of toxicity because of impaired excretion of the drug.

Because of the possibility of hemolytic anemia due to immature erythrocyte enzyme systems (glutathione
instability), the drug is contraindicated in pregnant patients at term (38-42 weeks gestation), during labor and
delivery, or when the onset of labor is imminent. For the same reason, the drug is contraindicated in neonates under
one month of age.

Macrobid is also contraindicated in those patients with known hypersensitivity to
nitrofurantoin.